COVID-19 Management Protocol by the Eastern Virginia Medical School

The Eastern Virginia Medical School – EVMS Medical Group – is providing guidance for healthcare providers treating COVID-19 patients. 

This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID.

The protocol we are covering here is dated May 5th. This protocol often changes daily. Please bookmark and share evms.edu/covidcare to find the most up-to-date version of the guidelines. 

Summary:

https://www.evms.edu/media/evms_public/departments/internal_medicine/Marik-Covid-Protocol-Summary.pdf

Protocol:

https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

The protocol was developed and is regularly updated by Paul E. Marik, MD, FCCP, FCCM, Professor of Internal Medicine (picture), whose impressive bio is presented below.

In his protocol, Professor Marik distinguishes 4 phases in the development of the disease: incubation, symptomatic, early pulmonary phase and late pulmonary phase.

The protocol covers not only treatment but also prophylaxis, with zinc, vitamin c, d and melatonin. It is stated that, “while there is no high-level evidence that this cocktail is effective; it is cheap, safe and widely available.” 

For symptomatic patients at home, are added to this, optionally, aspirin, hydroxychloroquine and monitoring with home pulse oxiometry.

The paper goes on to provide the protocol details for the later stages.

Regarding the escalation of respiratory support, it emphasizes to “Try to avoid intubation if at all possible.”

>>  Interview with Dr Altino de Almeida – Part 3

This is a Must Watch video presenting how the protocol, for advanced stages of the disease, is being implemented at Houston’s United Memorial Medical Center. The interviewed doctor is Dr Joseph Varon, MD, FACP, FCCP, FCCM, FRSM, who is a Pulmonologist and Clinical Professor of Medicine.

About Paul E. Marik, MD, FCCP, FCCM, Professor of Internal Medicine, Eastern Virginia Medical School

Dr Marik received his medical degree from the University of the Witwatersrand, Johannesburg, South Africa. He was an ICU attending at Baragwanath Hospital, in Soweto, South Africa. During this time he obtained a Master of Medicine Degree, Bachelor of Science Degree in Pharmacology, Diploma in Anesthesia as well as a Diploma in Tropical Medicine and Hygiene. Dr Marik did a Critical Care Fellowship in London, Ontario, Canada, during which time he was admitted as a Fellow to the Royal College of Physicians and Surgeon of Canada. Dr Marik has worked in various teaching hospitals in the US since 1992. He is board certified in Internal Medicine, Critical Care Medicine, Neurocritical Care and Nutrition Science. Dr Marik is currently Professor of Medicine and Chief of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School in Norfolk, Virginia. Dr Marik has written over 400 peer reviewed journal articles, 50 book chapters and authored four critical care books.

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